Jan 14

When they hear the word ‘depression’, many people think of sad or hopeless individuals who can’t cope with a life event, who are living withdrawn and are often crying their existence.

But in fact this is only rarely the case. In a U.S. study published in 1996, for example, only a third of the patients suffering from depression could name a stressful or dramatic experience that took place before the disease kicked in. And it is by no means only negative events that can trigger depression in some people, but also such as the birth of a child or winning a business contract. That not all people who experience dramatic events develop depression also suggests that other factors such as stress or genetic factors may be involved. For patients themselves or their environment is therefore usually not even possible to identify a potential reason for a probable depression – which usually leads to long delays in search for the correct diagnosis for the malaise they feel in.

Physical symptoms are another, often misinterpreted facet of depressive disorders. Headaches, insomnia, reduced memory and concentration, but also other kinds of physical pain, digestive problems or a general lack of energy are typical physical symptoms of depression.

The lack of perspective that is typical for depression, quite often also leads to self harm. Most people who commit suicide previously suffered from an (often unrecognized or untreated) depression. But it doesn’t need to be suicide: other self-defeating forms of behavior, such as alcohol and drug abuse, self-destructive eating habits or risky driving are, as studies illustrate, linked to depression in about 60% of the cases.

Particularly in older men, depression often manifests on aggression, particularly of the verbal kind, like ranting, looking down or lashing out on others or constant cynicism. Again, these persons are only rarely aware that they actually suffer from depression, but explain their inner discontent and anger with external circumstances over which they usually can’t complain too loudly and often.

About 20-25% of women and 7-12% of men suffers with depression at least once in their life time. However, the real figures are probably higher due to the frequent misdiagnoses and years of suffering without a proper diagnosis and adequate treatment.

(This short article is part of a weekly series dealing with psychological expat problems and general mental health issues and was published in various newspapers and magazines in Thailand, 2011)

Nov 18

How can we become happier in our lives, and what do we need to stay happy?

Researchers have put a lot of effort into answering these questions and came up with some interesting facts that define the scientific basis of the so-called ‘positive psychology’. Today we know that about 50% of one’s happiness depends on his or her genes. About 10-15% are a result of different measurable life circumstances variables, such as socioeconomic status, marital status, health, income, sex, age and others. Research in the US, for instance, has found that older Americans are generally happier than younger adults, or that 28% of those with an annual income of $35,000 described themselves as happy while 38% were of those bringing home $75,000 or more a year. The remaining 40% of factors influencing happiness, however, are mostly the results of actions that individuals deliberately engage in to become happier. This is also where we can also deliberately start to change something right away: physical exercise or eating chocolate, for example, are both proven to release endorphines which make us feel more energetic and happy. Proximity to other happy people was also found to be an important factor – if we have a tendency to isolate ourselves or to get stuck in negative emotions out of an inability to communicate them effectively or to resolve difficult situations, it comes as no surprise that happiness will not be a frequent visitor in our homes. Even worse: if conflicts are not resolved, we frequently end up in a downward spiral that can cause chronic distress, frustration and anger, and ultimately develop psychosomatic illness.

There is also extensive research data available now suggesting that religious people are happier and less stressed. It is not clear, however, whether this is because of the social contact and support that result from religious activities, the greater likelihood of behaviors related to good health (such as less substance abuse), or of a generally greater peace of mind (‘reason for being’, ‘life after death’). However, in countries where being without religion is not unusual, the happiness rates have to be found higher as well. So there is still much to be learned about the factors that influence happiness – but while we wait for the results, we can still aspire to improve the 40% we have control over.

(This short article is part of a weekly series dealing with psychological expat problems and general mental health issues and was published in various newspapers and magazines in Thailand, 2010)

Oct 28

Psychosomatic medicine is rooted in the idea of a mind-body connection, which recognizes that what a person experiences emotionally and mentally can affect his or her body. The medical community now fully recognizes the value of psychotherapy: today it is state of the art in Western clinics to offer patients complementary counseling or psychotherapy if they have to deal with severe diseases like cancer, genetic diseases, Parkinson’s disease, cardiovascular diseases and others, or if patients require surgery. Often, therapeutic counseling is also offered if someone has to deal with infertility, psychosomatic illness, allergies or other burdening physical problems where psychological factors might play a part.

psychotherapy has been shown to improve compliance and to reduce fears and phobias related to treatment procedures. It can further help reduce anxiety and depression, and to communicate better with the physicians. Observational studies evaluating the psychosocial status of patients with severe diseases like cancer even showed that patients with low levels of social and emotional support, or that suffered from chronic depression were more likely to die from cancer. Studies by S.Levy, for example, showed that breast cancer patients that had poor adjustment and lack of social support had a lower natural killer cell activity, and that natural killer cell activity predicted disease progression and disease recurrence.

However, even if some results of similar studies have shown insignificant results and though there has still lots of research to be done to find out about the correlation of well-being and physical recovery when having to face diseases, the fact that complementary counseling during treatment and recovery can strongly improve quality of living and contribute to a more balanced emotional state calls to consider counseling or psychotherapy as an important part in a holistic treatment approach. Way too often, patients recovering from surgeries or other effects of severe diseases develop depression or anxiety – and often enough it is on us – good friends or relatives – to help them regain their mental wellbeing and strength as well.

(This short article is part of a weekly series dealing with psychological expat problems and general mental health issues and was published in various newspapers and magazines in Thailand, 2010)

Jun 04

If everything goes well for Paul, he enjoys his life. But then there are the times when anxiety robs his sleep and even during the day he suffers from the fear of being seriously ill. A headache could be an indication of a brain tumor; swollen lymph nodes, diarrhea, or a birthmark could be a reference to cancer; the memory of a particular sexual adventure raises fear of having been infected with HIV.

Paul spends lots of time every day examining his body for suspicious signs and to gather information about possible symptoms. The Internet turns out to be a diabolical companion: vast amounts of information are openly available, but sometimes their reliability is doubtful, or certain contradictions turn up. Doctor visits also provide only temporary relief: couldn’t the doctor have been wrong or missed something?

Often people burdened by fears like Paul’s are intelligent, physically fit and live a very healthy lives. Their fears severely constrict the extent to which they can enjoy their lives. Short spells of relief are inevitably followed by the next phase of panic-like feelings of worry.

When suffering from such fears there is no need to be ashamed. This form of anxiety has causes that are not the affected persons’ fault and can be treated with strategies applied during psychotherapy or hypnotherapy – provided that there is a readiness to attend regular counselling sessions for a certain period. During the treatment new ways of dealing with these chronic concerns will be developed, relieving the heart from the heavy cloak of fear.

(This short article is part of a weekly series dealing with psychological expat problems and general mental health issues and was published in various newspapers and magazines in Thailand, 2010)

May 28

Violence is an ‘unforgettable’ valve. Already as a toddler, each of us learned that violence can at least provide short-term benefits – an experience which was stored deeply in the brain. From then on, whenever we don’t feel understood or not heard in a conflict, and in any situation that feels threatening, there will be at least a subconscious thought playing with the possibility of using psychological or physical violence to gain ground.

Education and maturation of our personality however allow us to learn other means of conflict resolution as well, which is the reason why very few adults are using physical violence. But then there are also people who find it harder than others to control their emotions. Their conflicts escalate much more easily: at first, mostly verbal, but sometimes they can end up in the form of physical attacks or reprisals.

The roots of the propensity to violence are almost always socially conditioned: the vast majority of perpetrators of violence grew up in economically poorer and atmospherically difficult families, often there are feelings of depression, a lack of perspective or a feeling of ‘not being able to achieve it.’

Unfortunately, the use of force almost always results in massive problems in partnerships, friends and society. Also, studies show that due to higher stress loads, the tendency to violence harms various organs and can make physically sick. Therefore, psychological and psychotherapeutic impulse control programs have been developed which can help affected people to learn regulate their emotions better and regain their ability to be ‘the boss of one’s body’.

(This short article is part of a weekly series dealing with psychological expat problems and general mental health issues and was published in various newspapers and magazines in Thailand, 2010)

May 13

A Connection for Life : Body and Psyche (Psychosomatic Illness)

All of us have heard of it – the ‘mysterious’ effects of the psyche on the human body. Indeed, latest studies show that we can imagine our constitution like the fuel pump in a car: its performance defines whether our ‘vehicle’ can drive with full force, if it starts to stutter – or in extreme cases even ceases its service. Whether our soul suffers or groans will always affect its ‘life partner’: our body.

Heart and circulatory diseases, such of the digestive system, problems with spine and joints, but also fluctuations in hormone levels or neurotransmitter imbalances: psychological burden is often a contributing cause. Also, mental states seem to influence the incidence of atopic dermatitis, diabetes and sexual problems as well as on the progression of cancer, as recent metastudies illustrate.

But let’s look the other way now and ask ourselves: what can we do to make it easier for our body? Most of all, it is important to cut down on all forms of stress (even if purely psychological), addictions and bad eating habits, all of which are often associated with depression as well. Meditation and Yoga are great to improve physical and mental balance. counseling and psychotherapy can help to get rid of the ‘millstones of the soul’ – often surprisingly quick – and thus relieve our bodies from the creeping loss of vitality and energy.

(This short article is part of a weekly series dealing with psychological expat problems and general mental health issues and was published in various newspapers and magazines in Thailand, 2010)